To Medicare Home Health Clients:
Important Regulatory Information
Medicare Advantage Payers
If you haven't done so already, contact your Medicare
Advantage payers to determine their billing requirements for 2022.
No changes will be needed for payers following Medicare billing
rules. If you bill any Medicare Advantage plans that have
different claim requirements in 2022, kindly submit that information in
writing to Netsmart Support via the support portal
at https://netsmartcares.force.com. Since CMS no longer provides a 60-day Grouper, new claim processing will no longer be supported for PPS 60-day billing.
Medicare Notice of Admission (NOA)
In
the upcoming weeks, Netsmart Support will be rolling out a new Medicare NOA
Electronic Option Set in preparation for the NOA submission requirement. You
may see this new option in your dropdown, but it will not be needed for use
until 1/1/2022.
Value Based Purchasing
On
1/8/2021, CMS announced that the Home Health Value Based Purchasing
(HHVBP) Model will be expanded to all Home Health agencies nationwide
effective 1/1/2022. Additional instructions will be provided in an
upcoming advisory once the changes have been published in the CMS Home
Health Final Rule.
Release 1.2.8.77 Changes
Medicare Billing
In
preparation for 2022 NOA submission requirements, the menus
below have been updated. Further instructions on NOA processing
and billing changes will be provided in a future advisory.
- Patient file > Certify tab has a
new checkbox to show or hide the 'Initial-Bill' date. The First-Visit
columns have been changed to 'FBV-Accrual' in preparation for 2022
revenue reporting.
- PPS Activity Report has been updated for NOA submission tracking.
Agency Cost Reporting
The
PPS Margin and Period Overview Reports and PPS Costing Assistant
have been updated to use the Cost Amount specified at the Charge Code
level (if found) rather than the System Settings modality average
costs for margin reporting. If the Cost Amount is not specified at the
Charge Code level, the average Modality cost will continue to be used.
Claims Status
A
Bill Type field has been added to display the X12 submission file type
(ex. RAP, Final, NOE, NOA) for easier file identification.
To Home Health & Hospice Billers:
Billing Audit
Starting
on or around 1/1/2022, the Billing Audit will only be accessible via
the Billing > Pre-Audit and Charge > Hospice LOC Reports. To
ensure proper edit checks are run, all billing should be initiated from
one of those two reports.
Refer
to Help>Release Info for a complete list of program changes included
in this release.
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